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RICE (rest, ice, compression, and elevation) can ease the pain and reduce inflammation due to a hand or wrist fracture. Immobilize the area by fashioning a splint out of any stiff material. Aspirin (for adults only) or another anti-inflammatory medication also eases pain and inflammation. Seek medical treatment as quickly as possible.
Often there are no immediate symptoms except for pain and limited range of motion in the hand. The person may think he or she has only a sprain; after a few hours, however, pain, swelling, and bruising usually, but not always, develop.
A fracture in the lower radius produces pain when the wrist is moved in any direction. A fractured scaphoid produces pain in the snuff box, the depression on the outer side of the wrist. Pushing the wrist backward can be especially painful. Pain or difficulty in moving the fingers could mean broken metacarpals.
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Having a heavy object fall on the hand, can break one or more of the metacarpal bones. The elderly whose bones are weakened by osteoporosis often break hand and wrist bones in even minor falls. Radiation treatments, long-term use of steroids, and cancer chemotherapy can also weaken bones and result in easy fractures.
Among young people, wrist fractures have become one of the most common injuries treated by orthopedists, thanks to the tremendous popularity of in-line skating. Hand and wrist fractures are also very common among football players, boxers, and other athletes who engage in contact sports.
There is little you can do to prevent torticollis, especially if it has no identifiable cause. Lifestyle changes, however, may help prevent wryneck. Maintain good posture at all times, keeping your shoulders down, and try to avoid sudden head movements.
ALTERNATIVE THERAPIES
Biofeedback training
~ This technique teaches patients how to control and relax neck muscles and is a standard treatment for wryneck.
Chiropractic
~ Many chiropractors specialize in treating wryneck using manipulation and electrical nerve stimulation. In rare cases this may result in serious complications, such as stroke.
Hydrotherapy
~ Whirlpool baths, alternating hot and cold showers, and underwater massage all provide varying degrees of relief for muscle spasms and neck pain.
Massage therapy
~ Combined with other therapies, massage can relax contracted muscles.
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A doctor will order various tests aimed at finding an underlying cause. Often, however, no specific cause can be found, and numerous treatments may be tried, including biofeedback and other unorthodox approaches. Many patients are gaining relief from a new treatment using injections of botolinum toxin. In addition to anti-inflammatory painkillers, medications that may help include:
~ Anticholinergic drugs such as trihexyphenidyl (Apo-Trihex), which work by blocking certain nerve impulses.
~ Muscle relaxants, such as diazepam, which help prevent spasms.
~ Antipsychotic drugs, such as haloperidol (Haldol) or perphenazine (Trilafon), which also relax muscle spasms.
If conservative approaches don’t work, neurosurgery to sever some of the neck nerves may help. In time, however, the problem may recur.
Warning: Babies born with congenital torticollis should be given intensive physical therapy within the first few months of life. The therapy is aimed at stretching the damaged muscle and allowing the baby to hold his or her head in a normal position.
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The discovery that injections of tiny amounts of botulinum toxin type A, commonly known as Botox, can relax spastic neck muscles has revolutionized the treatment of refractory torticollis. Botox, the toxin produced by the organisms that cause botulism – paralyzes the muscles, thereby relaxing the painful spasms and allowing the person to hold his head in a normal position. The effects of Botox last three to six months, after which the injections are repeated.
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Heat treatments sometimes ease the discomfort of simple wryneck. An anti-inflammatory painkiller, such as aspirin or ibuprofen, may help.
Try to sleep on your back, and use a small, rolled neck pillow. Use an inflatable traveler’s neck pillow. Use an inflatable traveler’s neck pillow on a long car or plane trip. For home use, consider investing in a special therapeutic pillow that can be cooled in the freezer to provide a cold treatment and then warmed in a microwave or oven set on low for a heat treatment.
If a painful muscle spasm develops, massage it with your fingers or rub it in a circular motion with an ice cube wrapped in a plastic bag. If you don’t obtain relief, try taking a hot shower to halt the spasms. Some patients also get relief from a battery-operated vibrating neck massager that can be worn like a scarf.
Torticollis is one of several diseases classified as focal dystonias, disorders in which specific muscles go into prolonged spasms. Wryneck is a mild form of torticollis, in which the spasms develop suddenly and may come and go. Usually, no cause can be found, although in some cases, the spasms are provoked by inflammation, a pinched nerve, a thyroid disorder, or a dislocated joint. After several years, symptoms often disappear.
Spasmodic torticollis tends to be more severe than wryneck, with the neck muscles remaining painfully contracted on one side, pulling the head toward the shoulder. The person may also suffer facial tics and other muscle spasms.
At one time, torticollis was thought to be caused by hysteria and was treated as a mental disorder. Although it can lead to emotional problems, doctors now know that torticollis is a mysterious organic disorder, rather than a mental illness, that requires medical treatment.
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Symptoms
* Painful spasms of the neck muscles, usually on one side.
* Muscle spasms that pull or twist the head to one side.
Who is at Risk?
About 1 in 10,000 in Canada suffer from wryneck or torticollis, neuromuscular disorders that can occur at any age but are most prevalent among people 30 to 50 years of age; women slightly outnumber men. Heredity may play a role; about 5 percent of torticollis patients have a family history of the disease. Congenital torticollis, which occurs mostly in newborns, is quite rare, and is usually due to an injured or malformed neck muscle.
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Note: The alternative therapies recommended for cervical disk disease may also relieve neck pain caused by muscle spasms, stress, and overuse injuries.
Aromatherapy: Lavender or marjoram oils are especially useful in easing minor aches and relaxing tensed muscles. They may be massaged into the neck skin or added to a hot bath.
Massage: Simply massaging a painful neck with your fingers often provides prompt relief; Rolling, shiatsu, or other deep massage techniques can alleviate deep muscle aches.
Meditation and yoga: These relaxation therapies, which may be combined with deep breathing exercises or self-hypnosis, can ease stress-related pain.
Warning! A stiff neck that is very painful or difficult to move and is accompanied by a worsening headache and possible fever may be caused by meningitis. This is potentially fatal disease; go a hospital emergency room right away.